Determination of Skeletal Age
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Iliac Apophysis - Risser's Sign
In general the long bone growth plates close at 15 to 17 years in males and 13 to 15 years of age in females.
An accurate way to determine the skeletal age of a child is to use an X ray of the left wrist and to compare it with X rays in the Greulich and Pyle atlas. Here a series of X rays showing the development and ossification of the wrist, and hand bones is displayed, together with the average age these appear.
The axial skeleton matures a few years later than the limbs, and for scoliosis,the Risser sign is a useful method of bone age determination.
Skeletal age can be determined by the appearance of the iliac apophysis
of the pelvis. The apophysis appears laterally on a pelvic X ray, and
moves towards the spine as the patient approaches adulthood. Risser's
sign is a measures the growth left in the spine - this may help to determine
the potential for progression of scoliosis.
Age determination in other areas
Other age determination systems are of value to the criminologist and immigration officials. It is sometimes crucial to determine if the individual is over 18 or 21, or at whatever age defines adulthood, and its attendant less lenient judicial treatment.
The third molar roots appear on X rays at age 18 years. The ossification of the sternal clavicular cartilage also occurs at age 18 years.
1.Greulich WW, Pyle SI: Radiographic Atlas of Skeletal Development of the Hand
and Wrist, 2nd edition. Stanford, . CA: Stanford University Press, 1959.